NUR 211 test 3

a loss of effect of the medication occurs near the end of the dosing intervals and indicates the plasma drug level has decreased to a subtherapeutic level. this is an expected occurrence with the medication and the chronic nature of the disease

the client diagnosed with parkinsons disease is taking levodopa and is experiencing an on/off effect. which action should the nurse take regarding this medication? a. document the occurrence and take no action b. request the HCP increase the dose of the medication c. discuss the clients imminent death as a result of this complication d. explain this is a desired effect of the medication

NSAID medications decrease prostaglandin production in the stomach resulting in less mucus production which creates a risk for the development of ulcers. the client should take the NSAID with food

the client with early stages RA is being discharged from the outpatient clinic. which discharge teaching should the nurse teach regarding the use of NSAIDS? a. take over the counter medication for the stomach b. drink a full glass of water with each pill c. is a dose is missed double the medication at the next dosing time d. avoid taking the NSAIDS on an empty stomach

a, e if the client does not have insurance to help pay for the medications the client may have trouble complying with the regimen. the current regimens include 4 or more daily medications costing more than 6000 per drug per year. many antiretroviral therapies have side effects that can be effectively treated, however if the client cannot tolerate the side effects the medication regimen can be altered

the clinic nurse is discussing medication compliance with a client diagnosed with AIDS. which information should the nurse discuss with the client? select all that apply a. the availability of insurance to pay for the medications b. whether the client wants to try to manage the disease without medications c. including OTC herbs in the medication regimen d. the importance of taking multiple vitamins at least 2 times a day e. the ability to change the medication regimen of side effects are not tolerable

a bisacodyl is a stimulant and should not be taken everyday because it will cause a decrease in the bowel tone. a client diagnosed with MS already has difficulty with bowel tone

the female client diagnosed with MS tells the nurse 'i am having problems having regular bowel movements' which statement by the client indicates the client needs more medication teaching? a. i am taking a stimulant laxative everyday b. i am taking a fiber laxative daily c. i take a stool softener at bed time d. i keep a glass of water with me at all times

d the client with a CD4 count of less than 300 is at risk for developing PJP. normal levels for CD4 are 450-1400.

the home health care nurse is caring for a client diagnosed with HIV. which data suggest the need for prophylaxis with trimethoprim sulfa? a. the client has positive HIV viral load b. the clients WBC is 5,000 c. the client has a hacking cough and dyspnea d. the clients CD4 count is less than 300

a the nurse would need further clarification for glucocorticoid prednisone steroid because the client is already immunosuppressed and this medication will further suppress the immune system

the home health care nurse is reviewing the list of daily medications the client diagnosed with AIDS is prescribed. which medication needs further clarification by the nurse? a. prednisone b. fluoxetine c. saquinavir d. nevirapine

c a potential suicide statement is priority for the nurse when caring for the client with MS

the home health nurse is caring for the client newly diagnosed with MS. which client issue is of most importance? a. the client refuses to have gastrectomy feedings b. the client wants to discuss if she should tell her fiance c. the client tells the nurse like is not worth living anymore d. the client needs the flu and pneumonia shots

d the client has the signs and symptoms of depression. the nurse should attempt to intervene with therapeutic conversation and discuss these findings with the HCP

the nurse is assessing a client diagnosed with RA. which assessment findings warrant immediate intervention? a. the client complaint of joint stiffness and the knees feel warm to the touch b. the client has experienced 1 kg weight loss and is very tired c. the client requires a heating pad applied to the hips and back to sleep d. the client is crying and has a flat facial affect and refuses to speak to the nurse

a the client with immunodeficiency has inadequate or absence of immune bodies and is at risk for infection. the priority nursing intervention would be to protect the client from infection.

the nurse is assisting in planning care for a client diagnosed with immunodeficiency and should incorporate which action as a priority in the plan? a. protecting the client for infection b. providing emotional support to decrease fear c. encouraging discussion about lifestyle changes d. identifying factors that decreased the immune function

a, e daytime somnolence is seen in about 22% of clients taking pramipexole, a dopamine agonist medication. a few clients experience an overwhelming and irresistible sleepiness that comes on without warning. stiff muscles are a sign of adverse side effects of pramipexole, a dopamine agonist medication indicating a need to discontinue the medication

the client diagnosed with early stage parkinsons has been prescribed pramipexole. which side effects of this medication should the nurse discuss with the client? select all that apply a. daytime solemnence b. on-off effect c. excessive salivation d. pill rolling motion e. stiff muscles

b difficulty swallowing places the client at risk for aspiration. immobility predisposes the client to pneumonia. both clinical manifestations place the client at risk for pulmonary complications

the client diagnosed with parkinsons disease in being admitted with a fever and patchy infiltrates in the lung fields on the chest xray. which clinical manifestations of PD would explain these assessment data? a. masklike facies and shuffling gait b. difficulty swallowing and immobility c. pinrolling of fingers and flat affect d. lack of arm swing and bradykinesia

d the major goal of treating PD os to maintain the ability to function. clients diagnosed with PD experience slow jerking movements and have difficulty performing routine daily tasks

the nurse is planning the care for a client diagnosed with parkinsons disease. which would be a therapeutic goal of treatment or the disease process? a. the client will experience periods of akinesia throughout the day b. the client will take prescribed medications correctly c. the client will be able to enjoy a family outing with the spouse d. the client will be able to carry out ADLs

b the goal for most clients diagnosed with a chronic disease is to maintain functional ability as long as possible

the nurse is preparing a care plan for a client diagnosed with parkinsons. which statement is the goal of medication therapy for the client diagnosed with PD? a. the medication will cure the client of PD b. the client will maintain functional ability c. the client will be able to take the medications as ordered d. the medication will control all the symptoms of PD

a pain medication is important and should be given before the clients pain becomes worse

the nurse is preparing to administer morning medications. which medication should the nurse administer first? a. pain medication to a client diagnosed with RA b. diuretic medication for a client with SLE c. steroid for client diagnosed with polymyositis appetite stimulant for someone diagnosed with OA

c scheduling appointments late in the morning gives the client a chance to complete ADLs without pressure and allows the medications time to give the best benefits

the client diagnosed with parkinsons disease is being discharged. which statement made by the significant other indicates an understanding of the discharge instructions? a. all of my spouses emotions will slow down just like his body movements b. my spouse may experience hallucinations until the medication starts working c. i will schedule appointments later in the morning after his morning bath d. it is fine if we dont follow a strict medication schedule on the weekends

a in parkinsons there is a decreased amount of dopamine in the brain. carbidopa delays the breakdown of levodopa (dopamine) in the periphery so that more of the levodopa crosses the blood brain barrier and reaches the brain

which statement is the scientific rationale for the combination drug carbidopa/levodopa prescribed to a client with parkinsons? a. the carbidopa delays the breakdown of the levodopa in the periphery so more dopamine gets to the brain b. the medication is less expensive when combined so it is more affordable to the clients c. the carbidopa breask down the periphery and causes vasoconstriction of the blood vessels d. carbidopa increases the action of levodopa on the renal arteries, increasing renal perfusion

b parkinsons is treated with medications and surgery. the medications have side effects and adverse effects and the effectiveness of the medications may be reduced over time

which statement made by the wife of a client with parkinsons indicates the medication teaching is effective? a. the medications will control every symptom of parkinsons if they are taken correctly b. the medication will provide symptom management but the effects may not last c. the medications will have to be taken for atleast 6 months and then stopped d. the medications much be tapered off when he is better or he will have a relapse

d standard precautions are used for all contact with blood and body secretions

which type of isolation technique is designed to decrease the risk of transmission of recognized and unrecognized sources of infection? a. contact b. airborne c. droplet d. standard

b Because anal intercourse allows contact of the infected semen with mucous membranes and causes tearing of mucous membrane there's a higher risk of transmission of HIV. HIV can be transmitted through oral or vaginal intercourse as well but not as easily

which of these patients cared for by the nurse in the clinic presents the highest risk for infection with HIV during sexual intercourse? a. uninfected man who reports performing oral intercourse with an HIV infected woman b. uninfected man who is the received during anal intercourse with an HIV infected man c. uninfected woman who has had vaginal intercourse with an HIV infected man d. uninfected woman who has performed oral intercourse with an HIV infected woman

a the priority goal is for this client to maintain functional ability. this improves quality and quantity of life

which priority goal would the nurse identify for a client diagnosed with parkinsons disease? a. the client will be able to maintain mobility and swallow without aspiration b. the client will verbalize feelings about the diagnosis of parkinsons disease c. the client will understand the purpose of medications administered for PD d. the client will have home health agency for monitoring at home

d entacapone is a catechol-o-methyltransferase (COMT) inhibitor that increases the half life of levodopa by 50-75% there by causing levodopa blood levels to be smoother and more sustained. this delays the 'off' effects and prolongs the 'on' effects of levodopa

which statement is an advantage of administering entacapone to a client diagnosed with parkinsons disease? a. entacapone increases the vasodilation effects of levodopa b. levodopa can be discontinued while the client is taking the entacapone c. there are no side effects of the drug to interfere with treatment d. entacapone causes blood levels of levodopa to be smoother and more sustained

B. This finding is known as Lhermitte's Sign.

You're performing a head-to-toe assessment on a patient with multiple sclerosis. When you ask the patient to move the head and neck downward the patient reports an "electric shock" sensation that travels down the body. You would report your finding to the doctor that the patient is experiencing:* A. Romberg's Sign B. Lhermitte's Sign C. Uhthoff's Sign D. Homan's Sign

B. Patients with RA can experience anemia. A hemoglobin level can be helpful in diagnosing anemia (a normal level in females is 12 to 15.5 g/dL). The patient's signs and symptoms above are classic findings in anemia.

You're providing care to a patient with severe rheumatoid arthritis. While performing the head-to-toe nursing assessment, you note the patient's overall skin color to be pale and the patient looks exhausted. You ask the patient how she is feeling, and she says "I'm so tired. I can't even get out of this bed without getting short of breath." Which finding on the patient's morning lab work may confirm a complication that can be experienced with rheumatoid arthritis?* A. Potassium 3.2 mEq/L B. Hemoglobin 7 g/dL C. Sodium 135 mEq/L D. WBC count 6,500

d the DMARD methotrexate is the most rapid acting DMARD but the therapeutic effects may not develop for 3-6 weeks

the client diagnosed with RA is prescribed methotrexate. after 3 days the client reports that the medication is not working. which statement is the clinic nurses best response? a. i will make you an appointment with the HCP immediately b. you are concerned that this medication is not going to work like the other ones? c. have you lost any more ROM in your upper extremitites d. that is normal because if take 3-6 weeks for the medication to work

d. Acetaminophen would be the most appropriate medication to give the client who is experiencing a headache and who is taking etodolac an NSAID

the client diagnosed with RA is taking etodolac. the client is reporting a headache. which intervention should the nurse implement? a. administer 2 aspirin b. administer an extra dose of etodolac c. administer one oral narcotic analgesic d. administer 2 acetaminophen tablets

b oxygen is a priority especially with a client diagnosed with a respiratory illness

the client diagnosed with pneumocystitis pneumonia (PCP) is being admitted to the ICU. which HCP order should the nurse implement first? a. draw a serum CD4 and CBC STAT b. administer oxygen to the client via NC c. administer trimethprim-sulfamethoxazole a sulfa antibiotic IVPB d. obtain a sputum specimen for culture and sensitivity

d many diagnostic tests are completed to rule out other diagnosis but parkinsons disease is diagnosed based on the clinical presentation of the client and the presence of 2 of 3 cardinal manifestations: tremor, muscle rigidity, and bradykinesia

the client is being evaluated to rule of parkinsons disease. which diagnostic test confirms this diagnosis? a. a positive MRI b. a biopsy of the substanti nigra c. a stereotactic pallidotomy d. there is no test that confirms this diagnosis

b methotrexate is a teratogenic and should not be used by patients who are pregnant. The healthcare provider will need to discuss the use of contraception during the time the patient is taking methotrexate. The other patient information may require further patient assessment or teaching but does not indicate that methotrexate maybe contra indicated for the patient

the nurse assesses a 24 year old patient with rheumatoid arthritis who is considering using methotrexate for treatment. which patient information is most important to communicate to the HCP? a. the patient has many concerns with the safety of the drug b. the patient has been trying to get pregnant c. the patient take a daily multivitamin tablet d. the patient says that she has taken methotrexate in the past

d the clients energy levels will not sustain eating for long periods. offering frequent and easy to chew meals of small proportions is the preferred dietary plan

the nurse caring for a client diagnosed with parkinsons writes a problem of impaired nutrition. which nursing intervention would b included in the plan of care? a. request the PT consult for equipment needed b. request a low fat, low sodium diet from the dietary department c. provide 3 meals per day that include nuts and whole grain breads d. offer 6 meals per day with soft consistency

a retroviruses never die. the virus may become dormant only to be reactivated at a later time

the nurse is describing the HIV virus infection to a client who has been told he is HIV positive. which information regarding the virus is important to teach? a. HIV is a retrovirus which means it never dies as long as it has a host. b. the virus can be eradicated from the host body with the correct medication regimen c. it is difficult for HIV virus to replicate in humans because it is a monkey virus d. the HIV virus uses the clients own red blood cells to produce the virus in the body

b the combination of specific medications depends on the health care facilities protocol, but most include a combination of 2 nucleoside reverse transcriptase inhibitors and a protease inhibitor. the CDC has a hotline that can be accessed for specific recommendations.

the nurse received a needle stick from a contaminated needle from a client diagnosed with AIDS. which medications should the nurse be started on within hours of the stick? a. a combination of antiviral and antifungal medications with an antibiotic b. a combination of a protease inhibitor and nucleoside reverse transcriptase inhibitors c. single agent therapy with a non-nucleoside transcriptase inhibitor d. no medications are recommended to prevent the conversion to HIV positive

d fetal transplantation has shown some success in PD, but it is an experimental and highly controversial procedure

the nurse researcher is working with the clients diagnosed with parkinsons. which is an example of experimental therapy? a. stereotactic pallidotomy/thalamotomy b. dopamine receptor agonist medication c. physical therapy for muscle training d. fetal tissue transplant

B, E, and F. These are DMARDs that can be prescribed for RA. Option A is a corticosteroid. Option C and D are sometimes prescribed in osteoporosis.

Disease-modifying antirheumatic drugs (DMARDS) are used to treat rheumatoid arthritis. Select-all-the drugs below that are DMARDS:* A. Dexamethasone (Decadron) B. Hydroxychloroquine (Plaquenil) C. Teriparatide (Forteo) D. Calcitonin E. Leflunomide (Arava) F. Methotrexate (Trexall)

C. The body attacks (specifically the WBCs) the synovium of the joint. The synovium becomes inflamed and this process is called synovitis. The inflammation of the synovium leads to thickening and the formation of a pannus, which is a layer of vascular fibrous tissue. The pannus will grow so large it will damage the bone and cartilage within the joint. The space in between the joints will disappear and anklyosis will develop, which is the fusion of the bone.

Identify the correct sequence in how rheumatoid arthritis develops:* A. Development of pannus, synovitis, ankylosis B. Anklyosis, development of pannus, synovitis C. Synovitis, development of pannus, anklyosis D. Synovitis, anklyosis, development of pannus

B and C. In multiple sclerosis the myelin sheath (which is the insulating and protective structure made up of Schwann cells that protects the axon) is damaged. MS affects the CNS (central nervous system) and when the myelin sheath becomes damaged it leads to a decrease in nerve transmission.

Select all the TRUE statements about the pathophysiology of multiple sclerosis:* A. "The dendrites on the neuron are overstimulated leading to the destruction of the axon." B. "The myelin sheath, which is made up of Schwann cells, is damaged along the axon." C. "This disease affects the insulating structure found on the neuron in the central nervous system." D. "The dopaminergic neurons in the part of the brain called substantia nigra have started to die."

False: MS affects WOMEN more than men and shows up during the ages of 20-40 years

True or False: Multiple Sclerosis tends to affect men more than women and occurs during the ages of 50-70 years.* True False

FALSE. Parkinson's Disease most commonly affects patients in OLDER adulthood (60+), and there is currently no cure for the disease.

True or False: Parkinson's Disease most commonly affects patients in young adulthood, and there is currently no cure for the disease.* True False

False: Yes, patients with MS have different signs and symptoms because lesions can present at different locations in the CENTRAL NERVOUS SYSTEM....hence the brain and spinal cord (not the peripheral nervous system).

True or False: Patients with multiple sclerosis have different signs and symptoms because this disease can affect various areas of the peripheral nervous system.* True False

False: Yes, RA tends to affect women more than men BUT it can affect all ages...most commonly 20-60 years old.

True or False: Rheumatoid arthritis tends to affect women more than men and people who are over the age of 60.* True False

c these are clinical manifestations of MS and can go undiagnosed for years because of the remitting-relapsing nature of the disease. fatigue and difficulty swallowing are other symptoms of MS

a 30 year old female is admitted with complaints of numbness, tingling, a crawling sensation affecting the extremities and double vision which has occurred 2 times in a month. which question is most important for the nurse to ask the client? a. have you experienced any difficulties with your menstrual cycle? b. have you noticed a rash across the bridge of your nose? c. do you get tired easily and sometimes have problems swallowing? d. are you taking birth control pills to prevent conception?

a at this time based on the clients statement related to being tired after physical therapy is the reason behind being unable to perform Adls. the other three are related to the diagnosis of MS but not related to the topic.

a client with MS tells the UAP after physical therapy that she is too tired to take a bath. what is the priority nursing concern at this time? a. fatigue b. inability to perform ADLs c. decreased mobility d. muscular weakness

c although all of these actions fall into the scope of practice for a UAP, the UAP should help the client with morning care as needed but the goal is to keep this client as independent and mobile as possible. the client should be encouraged to perform as much morning care as possible. assisting the client in ambulating, reminding them not to look at his feet to prevent falls, and encouraging the client to feed himself are all appropriate to the goal of maintaining independence

a client with parkinsons disease has a problem with decreased mobility related to neuromuscular impairment. the nurse observes the UAP performing all of these actions. for which action should the nurse intervene? a. helping the client ambulate to the bathroom and back to bed b. reminding the client not to look at his feet when he is walking c. performing the clients complete bathing and oral care d. setting up the clients tray and encouraging the client to feed himself

a administration of oral medication is included in the LPN/LVN education and scope of practice. Assessment plan of care and teaching are more complex RN level interventions

a hospitalized patient with AIDS has wasting syndrome. which nursing action is appropriate to assign to an LPN/LVN who is providing care to this patient? a. administering oxandrolone 5mg/day b. assessing the patient for other nutritional risk factors c. developing a plan of care to improve the patients appetite d. providing instructions about a high calorie, high protein diet

c the client diagnosed with RA has chronic pain therefore alteration in comfort is a priority problem

which client problem is priority for a client diagnosed with RA? a. activity intolerance b. F & E balance c. alteration in comfort d. excessive nutritional intake

A, C, and E. These are diagnostic tests to help diagnose RA. Option B is used in gout, and option D is used with osteoporosis.

A physician suspects a patient may have rheumatoid arthritis due to the patient's presenting symptoms. What diagnostic testing can be ordered to help a physician diagnose rheumatoid arthritis? Select all that apply:* A. Rheumatoid factor B. Uric acid level C. Erythrocyte sedimentation D. Dexa-Scan E. X-ray imaging

A. This medication is a DMARD and can cause retinal damage. Therefore, the patient should be monitored for vision changes.

A patient with rheumatoid arthritis is experiencing sudden vision changes. Which medication found in the patient's medication list can cause retinal damage?* A. Hydroxychloroquine (Plaquenil) B. Lefluomide (Arava) C. Sulfasalazine (Azulfidine) D. Methylprednisolone (Medrol)

B and D. During flare-ups of RA the joint should be rested (not exercised) and should not be deep massaged because this can further damage the joint (in addition cause the patient more pain). Heat therapy, like a warm shower or bath, will help alleviate the stiffness. Furthermore, cold therapy can be used to reduce the inflammation along with splinting the affected joints to protect and rest them.

A 58 year old female is experiencing a flare-up with rheumatoid arthritis. While assisting the patient with her morning routine, the patient verbalizes a pain rating of 7 on 1-10 scale in the right and left wrist along with severe stiffness. You note the wrist joints to be red, warm, and swollen. What nonpharmalogical nursing interventions can you provide to this patient to help alleviate pain and stiffness? Select-all-that-apply:* A. Exercise the affected joints B. Assist the patient with a warm shower or bath C. Perform deep massage therapy to the wrist joints D. Assist the patient with applying wrist splints

A, B, D. These are correct teaching points on how to deal with freeze ups in Parkinson's Disease.

A spouse of a husband who has Parkinson's Disease explains to you that her husband experiences episodes while walking where he freezes and can't move. She asks what can be done to help with these types of episodes to prevent injury. Select all the options that are correct:* A. Have the husband try to change direction of movement by moving in the opposite direction when the freeze ups occur. B. Use a cane with a laser point while walking. C. Have the husband try to push through the freeze ups. D. Encourage the husband to consciously lift the legs while walking (as with marching).

A. An arthrodesis (also called joint fusion) is where the affected joint is removed and the bones within it are fused together. Option B describes a joint replacement. Option C is known as a surgical cleaning. Option D is known as a synovectomy.

A patient with severe rheumatoid arthritis is scheduled for a procedure called an arthrodesis. The nursing student you are precepting asks what type of procedure this is. Your response is:* A. "It is a procedure where the affected joint is removed and each end of the bones found within that joint are fused together." B. "It is a procedure that involves replacing the joint with an artificial one." C. "It is a procedure where the surgeon goes in with a scope and cleans out the affected joint." D. "It is a procedure where the synovium is completely removed within the joint, which helps decrease inflammation of the joint.

A. This medication is contraindicated for patients with glaucoma.

A physician orders a patient to take Benztropine (Cogentin). The patient has never taken this medication before and is due to take the first dose at 1000. What statement by the patient requires you to hold the dose and notify the physician?* A. "I forgot to tell the doctor I take eye drops for my glaucoma." B. "I had a PET scan last week." C. "I take aspirin once day." D. "My hands are experiencing tremors at rest."

C. All the other options are CORRECT about this medication. However, the patient should avoid foods and supplements high in vitamin B 6 because it decreases the effectiveness of this medication.

A patient is prescribed to take Carbidopa/Levodopa (Sinemet). As the nurse you know that which statement is incorrect about this medication:* A. It can take up to 3 weeks for the patient to notice a decrease in signs and symptoms when beginning treatment with this medication. B. Body fluids can turn a dark color and stain clothes. C. This medication is most commonly prescribed with a vitamin B6 supplement. D. Carbidopa helps to prevent Levodopa from being broken down in the blood before it enters the brain. Hence, levodopa is able to enter the brain.

C. Interferon Beta decreases the number of relapses of symptoms in MS patients by decreasing the immune system response, but it lowers the white blood cells count. Hence, there is a risk of infection. It is very important the nurse stresses the importance of hand hygiene and avoiding infection.

A patient is receiving Interferon Beta for treatment of multiple sclerosis. As the nurse you will stress the importance of?* A. Physical exercise to improve fatigue B. Low fat diet C. Hand hygiene and avoiding infection D. Reporting ideation of suicide

A, B C, D, and H. If lesions are present on the optic nerves, optic neuritis can occurs which can lead to blurry vision, pain when moving the eyes, and dark spots in the vision. If cerebellar lesions are found, this can affect movement, speech, and some cognitive abilities. This would present as dysarthria (issues articulating words), and balance/coordination issues. "Pill rolling" of the fingers and hands is found in Parkinson's disease. Ptosis is common in myasthenia gravis, and heat intolerance in thyroid issues.

A patient is suspected of having multiple sclerosis. The neurologist orders various test. The patient's MRI results are back and show lesions on the cerebellum and optic nerve. What signs and symptoms below would correlate with this MRI finding in a patient with multiple sclerosis?* A. Blurry vision B. Pain when moving eyes C. Dysarthria D. Balance and coordination issues E. "Pill rolling" of fingers and hands G. Heat intolerance H. Dark spots in vision I. Ptosis

B, D, E. Rasagiline "Azilect" is a MAO Inhibitor Type B (Monoamine Oxidase Inhibitor). The patient should avoid foods high in tyramine which can cause a hypertensive crisis. This includes: aged cheese, smoked/cured meats, fermented food, beer.

A patient is taking Rasagiline "Azilect" for treatment of Parkinson's Disease. What foods do the patient want to limit in their diet? Select all that apply:* A. Liver B. Aged Cheese C. Sweetbread D. Beer E. Fermented foods F. Shellfish

A. The patient should have a diet of soft foods that are easy to swallow and chew. Option A is the only option that meets that specification.

A patient with Parkinson Disease is experiencing weight loss due to difficulty chewing and swallowing. Which meal option below is the best for this patient?* A. Scrambled eggs with a side of cottage cheese B. Grilled cheese with apple slices C. Baked chicken with bacon slices D. Tacos with refried beans

C. This is known as bradykinesia.

A patient with Parkinson's Disease has slow movements that affects their swallowing, facial expressions, and ability to coordinate movements. As the nurse you will document the patient has:* A. Akinesia B. "Freeze up" tremors C. Bradykinesia D. Pill-rolling

A. This medication is a cholinergic medication that will help with bladder emptying.

A patient with multiple sclerosis has issues with completely emptying the bladder. The physician orders the patient to take ___________, which will help with bladder emptying.* A. Bethanechol B. Oxybutynin C. Avonex D. Amantadine

D. Rubber sole shoes can make walking difficulty, especially when the patient has a shuffling gait because these type of shoes tend to stick to the floor and can cause the patient to trip. It is best to wear low heel, smooth soles (not slick or hard).

As the home health nurse you are helping a patient with Parkinson's Disease get dressed. What item gathered by the patient to wear should NOT be worn?* A. Velcro pants B. Pull over sweatshirt C. Non-slip socks D. Rubber sole shoes

C.

As the nurse you know that Parkinson's Disease tends to affect the _____________ of the midbrain, which leads to the depletion of the neurotransmitter ________________.* A. red nucleus, acetylcholine B. leminisci, norepinephrine C. substantia nigra, dopamine D. tectum nigra, dopamine

B and C. Patients with RA will experience pain and stiffness in the morning (for more than 30 minutes) not bedtime. It is common for patients to have a fever and be fatigued...remember RA affects the whole body not just the joints. It will also affect the same joints on the opposite side of the body. Therefore, if the right wrist is inflamed, painful, and stiff the left wrist will be as well. RA is NOT aggravated by extreme temperatures. This is found in osteoarthritis.

During a routine health check-up visit a patient states, "I've been experiencing severe pain and stiffness in my joints lately." As the nurse, you will ask the patient what questions to assess for other possible signs and symptoms of rheumatoid arthritis? Select-all-that-apply:* A. "Does the pain and stiffness tend to be the worst before bedtime?" B. "Are you experiencing fatigue and fever as well?" C. "Is your pain and stiffness symmetrical on the body?" D. "Is your pain and stiffness aggravated by extreme temperature changes?"

B, C, and F. The patient should also avoid extreme heat, which can increase symptoms.

During your discharge teaching to a patient with multiple sclerosis, you educate the patient on how to avoid increasing symptoms and relapses. You tell the patient to avoid:* A. Cold temperatures B. Infection C. Overexertion D. Salt F. Stress

B. This is an example of a positive Romberg's Sign.

Which finding below represents a positive Romberg Sign in a patient with multiple sclerosis?* A. The patient report dark spots in the visual fields during the confrontation visual field test. B. When the patient closes the eyes and stands with their feet together they start to lose their balance and sway back and forth. C. The patient's sign and symptoms increase when exposed to hot temperatures. D. The patient reports an electric shock feeling when the head and neck are moved downward.

C and D. These medications treat muscle spasms in patients with MS.

Which medications below can help treat muscle spasms in a patient with multiple sclerosis? Select all that apply:* A. Propranolol B. Isoniazid C. Baclofen D. Diazepam E. Modafinil

B. This is known as cogwheel rigidity, and occurs when the arms are passively moved, which will cause them to jerk slightly.

While assessing a patient with Parkinson's Disease, you note the patient's arms slightly jerk as you passively move them toward the patient's body. This is known as:* A. Lead Pipe Rigidity B. Cogwheel Rigidity C. Pronate Rigidity D. Flexor Rigidity

A. This medication is known to cause sudden drowsiness that can cause a person to randomly fall asleep. Therefore, it is PRIORITY to teach the patient to not take this medication when they be driving or operating machinery etc...to prevent injury.

While providing discharge teaching to a patient prescribed Ropinirole (Requip), you make it priority to teach the patient about what side effect?* A. Drowsiness B. Dry mouth C. Coughing D. Dark sweat or saliva

B. During flare-ups of RA the patient should rest the joint. However, it is important the patient performs range of motion exercises along with LOW-IMPACT exercise weekly (such as stationary bike riding, walking, water aerobics etc.). This will help with increasing the patient's energy level along with muscle strength and maintain joint health.

You are providing education to a patient, who was recently diagnosed with rheumatoid arthritis, about physical exercise. Which statement made by the patient is correct?* A. "It is best I try to incorporate a moderate level of high impact exercises weekly into my routine, such as running and aerobics." B. "I will be sure to rest joints that are experiencing a flare-up, but I will try to maintain a weekly regime of range of motion exercises along with walking and riding a stationary bike." C. "It is important I perform range of motion exercises during joint flare-ups and incorporate low-impact exercises into my daily routine." D. "Physical exercise should be limited to only range of motion exercises to prevent further joint damage."

A. This option is the only one that is INCORRECT. Tremors in Parkinson's Disease tend to occurs at rest and will actually improve with movement.

You're caring for a patient with Parkinson's Disease that has tremors. Select the option that is INCORRECT about tremors experienced in this disease:* A. The tremors are most likely to occur with purposeful movements. B. A common term used to describe the tremors in the hands and fingers is called "pill-rolling". C. Tremors are one of the most common signs and symptoms in Parkinson's Disease. D. Tremors in this disease can occur in the hands, fingers, arms, legs and even the lips and tongue.

B and D. Uhthoff's Sign is where when the patient experiences too much heat their symptoms increase and get worst. Therefore, it is important the patient stays cool and doesn't overheat (overheating can come from outside temperatures, exercise, emotional events etc.). The room should be cool and the patient should be encouraged to exercise but to avoid overheating.

You're developing a plan of care for a patient with multiple sclerosis who presents with Uhthoff's Sign. What interventions will you include in the patient's plan of care? Select all that apply:* A. Avoid movements of the head and neck downward B. Keep room temperature cool C. Encourage patient to use warm packs and heating pads for symptoms D. Educate the patient on three ways to avoid overheating during exercise

C. Entacapone "Comtan" (is a catechol-O-methyltransferase inhibitors) and is used with levodopa/carbidopa to prevent the "wearing off" of the drug before the next dose is due. It blocks the COMT enzyme that will break down the levodopa in the blood to allow it to last longer.

You're patient with Parkinson's Disease has been taking Carbidopa/Levodopa for several years. The patient reports that his signs and symptoms actually become worse before the next dose of medication is due. As the nurse, you know what medication can be prescribed with this medication to help decrease this for happening?* A. Anticholinergic (Benztropine) B. Dopamine agonists (Ropinirole) C. COMT Inhibitor (Entacapone) D: Beta blockers (Metoprolol)

B and D. Constipation (not diarrhea) is a common symptom with Parkinson's Disease. Therefore, the patient should be vigilant about preventing constipation by EATING foods high in fiber like fruits/vegetable and drinking 2 L of fluid per day (unless contraindicated). In addition, diet teaching should be included with the medication Carbidopa/Levodopa. The patient should NOT take this medication with a protein rich meal because levodopa competes with protein in the small intestine (hence decreasing it absorption).

You're providing diet education to a patient with Parkinson's Disease. Which statement below demonstrates the patient understood your teaching? Select all that apply:* A. "I will limit foods high in fiber like fruits and vegetables in my diet." B. "I will be sure to drink 2 Liter of fluid per day." C. "It is very common for me to experience diarrhea with this disease." D. "I will avoid taking Carbidopa/Levodopa with a protein rich meal."

B, C, E, F, H. These are all signs and symptoms experienced with PD (they vary among patients). There is NOT increased salivation (although drooling occurs...this is due to the decreased ability to swallow). There are tremors at REST (not purposeful movement) along with depression rather the euphoria.

You're providing free education to a local community group about the signs and symptoms of Parkinson's Disease. Select all the signs and symptoms a patient could experience with this disease:* A. Increased Salivation B. Loss of smell C. Constipation D. Tremors with purposeful movement E. Shuffling of gait F. Freezing of extremities G. Euphoria H. Coordination issues

B. These specific proteins, oligoclonal bands, which are immunoglobulins will be found in the CSF. This demonstrates there is inflammation in the CNS and is a common finding in multiple sclerosis.

Your patient is scheduled for a lumbar puncture to help diagnose multiple sclerosis. The patient wants clarification about what will be found in the cerebrospinal fluid during the lumbar puncture to confirm the diagnosis of MS. You explain that ____________ will be present in the fluid if MS is present.* A. high amounts of IgM B. oligoclonal bands C. low amounts of WBC D. oblong red blood cells and glucose

d Your purpose of HIV testing for asymptomatic patients is to ensure that HIV positive individuals are aware of their HIV status, take actions to prevent HIV transmission and effectively treat HIV infection. According to current national guidelines the other actions are also appropriate but the initial action will be to communicate the test results to the patient. Rapid HIV testing must be confirmed by another test usually the Western blot test. Anti-retroviral therapy is recommended for all HIV Does the patients. Risk factors information will be used in tracking patient contacts and in teaching the patient how to reduce the risk for transmission to others

a patient seen in the STD clinic has tested positive for HIV with a rapid HIV test. which action will the nurse take next? a. ask the patient about risk factors for HIV infection b. send a blood specimen for a western blot test c. provide information about antiretroviral therapy d. discuss the positive test results with the patient

b Because protease inhibitors decrease the metabolism of many drugs including Midazolam serious toxicity can develop when protease inhibitors are given with other medications. Midazolam should not be given to this patient. The other patient data are consistent with the patient diagnosis of panic attack and do not indicate an urgent need to communicate with the provider

a patient who has HIV and is taking nucleoside reverse transcriptase inhibitors and a protease inhibitor is admitted to the psych unit with a panic attack. which information about the patient is most important to discuss with the HCP? a. the patient exclaims 'im afraid im going to die right here' b. the prescribed patient medications include midazolam 2mg IV immediately c. the patient is diaphoretic and tremulous and reports dizziness d. the symptoms occurred suddenly while the patient was driving to work

d Viral load testing measures the amount of HIV genetic material in the blood so decrease in viral load in the case of the anti-retroviral therapy is effective. The CD4 level, total lymphocytes and CBC will also be used to assess the impact of HIV and immune function but not directly measure the effectiveness of anti-retroviral therapy

a patient with HIV who has been started on antiretroviral therapy is seen in the clinic for a follow up. which test will be best to monitor when determining the response to therapy? a. CD4 level b. CBC c. total lymphocyte response d. viral load

a Cording to the NIH guidelines and induration of 5 mm or greater indicates TB infection in patients with HIV and a chest radiograph will be needed to determine whether the patient has active or Latent TB infection. Teaching about multi drug therapy is needed if the patient has active TB but latent TB is treated with a single drug only. Positive skin test results generally persist throughout the patient's lifetime and will not be repeated although other tests such as follow up chest radiograph and sputumTesting maybe you to valuate for effective TB treatment

a patient with newly diagnosed AIDS has a 6mm induration at 48 hours ofter a skin test for TB. which action will the nurse anticipate taking next? a. arrange for a chest xray to check for active TB b. tell the patient the TB test results are negative c. teach the patient about multidrug treatment for TB d. schedule TB testing again in 12 months

a, c, e UAP education and scope of practice include checking pulse and BP measurements. the nurse would be sure to instruct the UAP to report HR and BP findings. in addition UAPs can reinforce previous teaching or skills taught by the RN or by personnel in other disciplines like PT or ST. evaluating medication is within the RN scope of practice

all if the following nursing care activities are included in the care plan for a 78 year old man with parkinsons disease who has been referred to home health agency. which activities will the nurse delegate to the UAP? select all that apply a. check for orthostatic changes in pulse and BP b. assessing for improvement in tremor after levodopa is given c. reminding the client to allow adequate time for meals d. monitoring for signs of toxic reactions to anti-parkinsons medications e. assisting the client with prescribed strengthening exercises f. adapting the clients preferred activities to his level of function

c steroids interfere with glucose metabolism by blocking the action of insulin, therefore the blood glucose levels should be monitored

the client diagnosed with an acute exacerbation of MS is placed on high dose IV injections of corticosteroid medication. which nursing intervention should be implemented? a. discuss discontinuing the PPI with the HCP b. hold the medication until all the cultures have been obtained c. monitor the clients blood glucose levels frequently d. provide supplemental dietary sodium with the clients meals

b Tumor necrosis factor antagonist such as etanercept suppress immune function and increase the risk for reactivation of latent TB. further assessment for and possible treatment of TB will be needed before starting etanercept therapy. The other data will be communicated and may require patient monitoring for teaching they're not contraindications to starting etanercept

initiation of subcutaneous etanercept for a patient with rheumatoid arthritis is being considered. which patient information is most important for the nburse to communicate with the HCP? a. the patient is currently taking methotrexate b. the patient has a positive tb skin test c. the patient has had type 2 diabetes for 5 years d. the patient is anxious about having to self inject

b ganciclovir and acyclovir an antiviral medication are teratogenic and carcinogenic there for it must be disposed of in a manner that protects the environment. it should be burned at a high temperature to prevent the chemical from reaching the environment

the client diagnosed with AIDS is receiving IV acyclovir. which intervention should the home health nurse implement when administering this medication? a. restrict all visitors when administering this medication b. arrange for IV tubing and bag to be incinerated c. store reconstituted solutions at room temperature d. have the pharmacy mix the medication for 1 week at a time

c the first action by the nurse is to administer a small test dose of amphotericin B (fungizone), an antifungal agent, to assess for the clients potential response

the client diagnosed with AIDS is to receive an initial dose of amphoticericin B. which intervention should the nurse implement first? a. administer IV piggyback in 500mL of D5W over 6 hours b. administer meperidine 25 mg IV push over 5 minutes c. administer a test dose of 1mg over 20 minutes d. administer tylenol 650mg orally

a, b, c, e these are all the first line therapy for a client diagnosed with TB

the client diagnosed with HIV has a positive test for TB. which medication should the nurse anticipate? select all that apply a. isoniazid b. ethambutol c. pyrazinamide d. enfuvirtide e. rifampin

b biologic response modifier interferon beta-1a can reduce the frequency of relapse by 30% and decrease the appearance of new lesions on the MRI by 80%. the decrease in the appearance of new lesions indicates the medication is effective

the client diagnosed with MS is being treated with interferon beta-1a. which diagnostic tests should the nurse monitor to determine the effectiveness of the medication? a. the CSF WBC count b. the MRI scan c. an electromyogram d. an EEG

the drug requires close monitoring to prevent organ damage

the client diagnosed with RA who has been prescribed etanercept, a tumor necrosis factor alpha inhibitor shows marked improvement. which instruction regarding the use of this medication should the nurse teach? a. explain the medication loses the efficacy after a few months b. continue to have check ups and lab work while taking this medication c. have yearly MRIs to follow the progress d. discuss the drug is taken for 3 weeks and then stopped for a week

a immunosuppressive medications are considered class c drugs and should not be taken while pregnant. these drugs are teratogenic and carcinogenic and the client is only 20 years old

the 20 year old female client is diagnosed with advanced unremitting RA is being admitted to receive a regimen of immunosuppressive medications. which question should the nurse ask during the administration process regarding the medications? a. are you sexually active, if so are you using birth control? b. have you discussed taking these medications with your parents? c. which arm do you prefer to have an IV in for 4 days? d. have you signed an informed consent for investigational drugs?

d the client should make personal choices about end of life issues while it is possible to do so. this client is progressing toward immobility and all the complications related to it

the 45 year old client is diagnosed with primary progressive MS and the nurse writes the diagnosis 'anticipatory grieving related to progressive loss.' which intervention should be implemented first? a. consult the PT for assistive devices for mobility b. determine if the client has a legal POA c. ask the client if they would like to talk to the chaplain d. discuss the clients wishes regarding end of life care

a headache and photophobia are expected clinical manifestations of meningitis. the new graduate would care for this client

the charge nurse is making assignments. which client should be assigned to the new graduate nurse? a. the client with aseptic meningitis who is complaining of a headache and the light bothering his eyes b. the client diagnosed with parkinsons who fell during the night and is complaining of difficulty walking c. the client who had a CVA whose vital signs are P 60, R 14, and BP 189/68 d. the client diagnosed with a brain tumor who has anew complaint of seeing spots before the eyes

c, e initial therapy is IV and care must be taken not to infuse the medication too rapidly. the infusion should be administered on a pump over 1 hour. ganciclovir (cytovene) is administered twice a day during the first few weeks of treatment then once a day 5-7 times a week

the client diagnosed with AIDS and cytomegalovirus retinitis is prescribed gancoclovir. the client has a single lumen implanted port. which information about the medication should the nurse discuss with the client? select all that apply a. the client will have to take the medication for the rest of his life b. the client will take the medication for 1 week each month c. he medication should infuse over 1 hour via infusion pump d. the medication can run simultaneously with the clients TPN e. the medication is administered BID for the first few weeks of treatment

c the health care team should meet to discuss ways to help the client deal with anger being expressed and the staff should be consistent in working with the client

the client diagnosed with AIDS is angry and yells at everyone entering the room and none of the staff members wants to care for the client. which intervention is most appropriate for the nurse manager to use in resolving this situation? a. assign a different nurse every shift to the client b. ask the HCP to tell the client not to yell at the staff c. call a team meeting and discuss options with the staff d. tell one staff member to care for the client a week at a time

b this most likely is a fungal infection known as oral candidiasis commonly known as thrush. an antifungal medication is needed to treat this condition

the client diagnosed with AIDS is complaining of a sore mouth and tongue. when the nurse assesses the buccal musoca the nurse notes white patchy lesions covering the hard and soft palates and the right inner cheek. which interventions should the nurse implement? a. teach the client to brush teeth and patchy area with a soft bristle tooth brush b. notify the HCP for an order for an antifungal swish and swallow medication c. have the client gargle with an antiseptic based mouth wash several times a day d. determine what types of food the client have been eating in the last 24 hours

a the current treatment is a combination of highly active antiretroviral therapy (HAART) medications. these medications can decrease HIV detectable levels with current technology. they are not a cure, are expensive, and have serious side effects, but the mortality rate from AIDS has decreased 70% with this therapy

the client diagnosed with AIDS is prescribed a combination of protease inhibitor, non-nucleoside reverse transcriptase inhibitor, and 2 nucleoside reverse transcriptase inhibitors. which statement best describes the scientific rationale for combining these medications? a. the combination prevents or delays the clients complications from HIV infection b. multiple medications are needed to eradicate all of the HIV infection c. the combination of medications is less expensive than hospitalization for HIV d. protease inhibitors counteract the side effects of the other medications

e, b, c, a, d the nurse must determine that the right medication is being given to the right client. then the nurse should assess the IV placement prior to administering the medication, if there is blood return the catheter is in the vein. the nurse should flush the catheter with NS prior to administration to make sure all of the previous medication is clear from the catheter. glucocorticoid hydrocortisone can be administered safely over 1-2 minutes. the final step is to flush the saline lock to make sure the client receives all the prescribed medication

the client diagnosed with MS is prescribed IV hydrocortisone. the client has a saline lock. which procedures should the nurse follow when administering this medication? rank in order of performance a. administer the diluted medication IV over 1-2 minutes b. aspirate the syringe to obtain a blood specimen c. flush the saline lock with 2mL of sterile NS d. flush the saline lock again with 2mL NS e. check the clients ID bands against the MAR

b, c, e antispasmodic baclofen can cause urinary urgency so this should be assessed. antispasmodic baclofen is administered to treat the spasticity associated with MS. the nurse should assess for muscle spasticity, rigidity, movement, and pain to determine the effectiveness of the medication.

the client diagnosed with MS is prescribed baclofen. which data should the nurse assess? select all that apply a. the clients serum baclofen levels b. the clients report of urinary retention c. the clients muscle rigidity and ROM d. the clients BUN and creatinine levels e. the clients spasticity and pain

MRI scans require the client to lie still and not move the body, the client should be warned about the loud noise

the client diagnosed with MS is scheduled for an MRI of the head. which information should the nurse teach the client about this test? a. the client will have wires attached to the scalp and lights will flash on and off b. the machine will be loud and the client must not move the head during the test c. the client will drink a contrast drink 30 minutes to 1 hours before the test d. the test will be repeated at intervals during a 5-6 hours period

b the RBC count indicates anemia which would warrant intervention by the nurse. the normal RBCis 4.6-6.0 for men and 4.0-5.0 for women

the client diagnosed with RA has been taking methotrexate for 2 weeks. which lab data warrants intervention by the nurse? a. serum creatinine level of 0.9 b. a RBC count of 2.5 million c. a WBC count of 9,000 d. a HGB level of 14.5 and HCT level of 43%

b the occupational therapist assists the client in the use of the upper body, fine motor skills, and ADLs. this is needed for the client with abnormal fingers

the client diagnosed with RA has developed swan neck fingers. which referral is most appropriate for the client? a. physical therapy b. occupational therapy c. psych consul d. home health nurse

c RA is a disease with may immunological abnormalities. the clients have increased susceptibility to infectious disease such as the flu or pneumonia and there fore vaccines which are preventative should be recommended

the client diagnosed with RA is being seen in an outpatient clinic. which preventative care should the nurse include in the regularly scheduled clinic visits? a. perform joint xrays to determine progression of the disease b. send blood to the lab for an erythrocyte sedimentation rate c. recommend the fl and pneumonia vaccines d. assess the client for increasing joint involvement

d, e the cream capsaicin a topical analgesic should be rubbed into the skin until little or no cream is left on the surface of the skin. the hands should be washed immediately after the cream is applied to the skin with soap or vinegar so the client does not accidently spread to the eyes, nose or mouth

the client diagnosed with RA is prescribed capsaicin. which information should the nurse discuss with the client? select all that apply a. apply the cream as needed fro severe arthritic pain b. notify the HCP if burning of the skin occurs after application c. it may take up to 3 months for the medication to become effective d. rub the cream into the skin until no cream is left on the surface e. wash hands with vinegar or soap after the application of the cream

b prednisone a glucocorticoid has serious long term side effects that can lead to possible life threatening complications, therefore the client cannot take prednisone forever

the client diagnosed with RA is prescribed prednisone for an active episode of pain. the client asks 'why cant i be on this forever since it helps the pain so much?' which statement by the nurse is the best response? a. the medication will cause you to have a moon face or buffalo hump b. the medication has long term effects such as osteoporosis c. if you continue taking the medication it will cause you to have an addisonian crisis d. there are other medications that can help with the pain

c the DMARD leflunomide is teratogenic. women must undergo the drug elimination procedure and men must take 8 grams of cholestyramine 3 times a day for 11 days to minimize any possible risk of harm to the fetus his partner is carrying

the client diagnosed with RA is taking leflunomide. which comment by the client warrants immediate intervention by the nurse? a. i have noticed that i am starting to lose my hair b. i sometimes get dizzy and drowsy c. my spouse and i are trying to start a family d. i will not get any vaccines while taking this medication

a the most dangerous adverse reaction to phenylbutazone a pyrazoline NSAID, is blood dyscrasias, which are manifested in the client by flu-like symptoms

the client diagnosed with RA is taking phenylbutazone. which statement requires the nurse to question administering this medication? a. i have had a sore throat and fever the last few days b. i have had a BM in more than 3 days c. i cant believe i have gained 3 pounds in the last month d. i have been having trouble sleeping at night

a, b, e the client should take hydroxychloroquine medication with meals or milk to reduce GI distress. alcohol should be avoided because it will increase the possibility of liver toxicity. hydroxychloroquine can cause retinopathy, blurred vision, and difficulty focusing, therefore the client should have periodic eye examinations

the client diagnosed with RA is undergoing long term therapy with hydroxychloroquine. which actions by the client indicate compliance with the medication teaching? select all that apply a. the client takes medication with food b. the client does not drink any alcoholic beverages c. the client drinks atleast 3000 mL water daily d. the client has not had any unexplained weight loss e. the client sees the opthalmologist every 6 months

b the nurse should teach the side effects of medications the client is prescribed. safinamide side effects include orthostatic hypotension, dyskinesia, worsening of PD symptoms, falls, insomnia, cough, cataracts and indigestion. the client should notify the HCP if these occur. the medication started at 50mg per day for 2 weeks then increased to 100 mg per day after that

the client diagnosed with parkinsons has been on carbidopa/levodopa for 2 years and now the symptoms have increased. the HCP added the prescription safinamide to the clients daily routine. which information should the nurse teach the client? a. D/C carbidopa/levodopa b. rise slowly from a lying or sitting position c. take the medication on an empty stomach d. there are no side effects of this medication like there are for carbidopa/levodopa

b with long term use of levodopa an antiparkinsons medication, the adverse effects may tend to increase and the client may develop a drug tolerance where the therapeutic effects decrease. a short hiatus from the medication (10 days) may result in beneficial effects being achieved with lower doses

the client diagnosed with parkinsons has been on long term levodopa. which data supports the rationale for placing the client on a 'drug holiday'? a. the medication is expensive and difficult to afford for clients on a fixed income b. the therapeutic effects of the drug have diminished and the adverse effects have increased c. the client has developed HTN that is uncontrolled by medication d. an overdose is being taken and the medication needs to clear the system

b the effectiveness of amatadine may diminish in 3-6 months. if s/s of parkinsons recur, the client should notify the HCP

the client diagnosed with parkinsons is prescribed amantidine. which information should the nurse teach the client? a. do not get the flu vaccine because there may be interactions b. if the symptoms return you should notify the HCP c. the dose should be decreased if you are taking other parkinsons medications d. if a dry mouth occurs discontinue the medication immediately

c carbidopa enhances the effects of levodopa be inhibiting decarboxylase in the periphery, thereby making more levodopa available to the CNS. sinemet is the most effective treatment for PD

the client diagnsoed with parkinsons disease is being discharged on carbidopa/levodopa (sinemet) an antiparkinsonal medication. which statement is the scientific rationale for combining these medications? a. there will be fewer side effects with this combination that with carbidopa aline b. dopamine d requires the presence of both of these medications to work c. carbidopa makes more levodopa available to the brain d. carbidopa crosses the blood brain barrier to treat parkinsons disease

a the exact causes of MS is not known but there a theory stating a slow virus is partially responsible. a failure of a part of the immune system may also be at fault. a genetic predisposition involving chromosomes 2, 3, 7, 11, 17, 19 and x may be involved

the client newly diagnosed with MS states 'i dont understand how i got MS. is it genetic?' on which statement should the nurse base their response? a. genetics may play a susceptibility to MS but the disease may be caused by a virus b. there is no evidence suggesting there is any chromosomal involvement in developing MS c. MS is caused by a recessive gene which means both parents need to be carriers of the gene for the client to get MS d. MS is caused by an autosomal dominant gene on the y chromosome so only fathers can pass it on

d safety is always an issue with a client with diminished mental capacity

the client on a medical floor is diagnosed with HIV encephalopathy. which client problem is priority? a. altered nutrition, less than body requirements b. anticipatory grieving c. knowledge deficit, procedures, and prognosis d. risk for injury

c the aspirin should be taken in divided doses (3-4 325mg tablets 4 times a day) this statement indicates the client needs more teaching

the client recently diagnosed with RA is prescribed 4 grams of aspirin daily. which statement indicates the client needs more teaching concerning the medication? a. i will decrease my dose for a few days if my ears start ringing b. i should take my aspirin with meals, snacks, milk, or antacids c. i need to take the entire aspirin at night before going to bed d. if i have an upset stomach i will take enteric coated aspirin

c the primary phase of infection ranges from being asymptomatic to severe flu like symptoms but during this time the test may be negative although the individual is infected with HIV

the client who has engaged in needle sharing activities has developed flu like infection. an HIV antibody test is negative. which statement best described the scientific rationale for this finding? a. the client is fortunate enough to not have transmitted HIV from an infected needle b. the client must b repeatedly exposed to HIV before becoming infected c. the client may be in the primary infection phase of an HIV infection d. the antibody test is negative because the client has a different flu virus

a an antibiotic trimethoprim-sulfamethoxazole sulfa allergy with this type of rash develops in up to 60% of clients diagnosed with AIDS

the client with AIDS has a pruritic rash with pink-red macules. which medication should the nurse expect is causing the rash? a. trimethoprim-sulfamethoxazole b. nelfinavir c. efavirenz d. zidovudine

a the nodules may appear over bony prominences and resolve simultaneously. they appear in client with rheumatoid factor and are associated with rapidly progressive and destructive diseases

the client with RA has nontender, moveable nodules in the subcutaneous tissue over the elbows and shoulders. which statement is the scientific rationale for the nodules? a. the nodules indicate a rapidly progressive destruction fo the affected tissue b. the nodules are small amounts of synovial fluid that have become crystallized c. the nodules are lymph nodes which have proliferated to try to fight the disease d. the nodules present a favorable prognosis and mean the client is better

d, e the medication is a DMARD, which takes 3-6 months to achieve the desired response and many clients do not experience significant benefits. loss of balance and coordination is an adverse effect of the medication and should notify the HCP

the client with RA is prescribed hydroxychloroquine sulfate. which statements indicate the client needs more teaching concerning the medication? select all that apply a. i will get my eyes checked every 6 months b. i should not drink alcohol while taking this medication c. it is important to take this medication with milk d. i will call my HCP if the pain is not relieved in 2 weeks e. it is common to have a loss of balance while taking this medication

b, c, d leucovorin is the 'rescue factor' to prevent an adverse reaction to trimextrate (neutrexin). the nurse should have both medications infusing simultaneously. the medication can cause myelosuppression and the CBC should be monitored by the nurse. the medication can cause a transient elevation in the clients liver enzymes, therefore the nurse should monitor this lab result

the intensive care nurse is preparing to administer trimetrexate to a client with AIDS and pneumocystis jiroveci pneumonia. which interventions should the nurse implement? select all that apply a. administer IV via gravity infusion b. administer concurrently with leucovorin c. monitor the clients CBC d. monitor the clients liver enzymes e. maintain NPO during drug administration

c children taking prednisolone are more prone to infection and should avoid exposure to measles or chicken pox while taking prednisolone

the male 4 year old client is prescribed prednisolone for juvenile arthritis. which statement by the childs mother warrants immediate intervention by the nurse? a. my child is current with all of his vaccinations b. i can crush the tablet and put in some of his favorite pudding c. my 2 year old daughter is at home with chicken pox d. i need to notify my HCP if my sons temp rises above 100.0

a the nurse should listen without being judgmental about any alternative therapy the client is considering. alternative therapies such as massage and relaxation are frequently beneficial and enhance the medical regimen

the male client diagnosed with MS stated he has been investigating alternative therapies to treat his disease. which intervention is most appropriate by the nurse? a. encourage therapy if it is not contraindicated by the medical regimen b. tell the client only the HCP should discuss this with them c. ask his his significant other feels about this deviation from the medication regimen d. suggest the client research an investigational therapy instead

b these are the causes of the tremors, cogwheel motion of movement and bradykinesia and so forth. it is also in laymans terms that the client can understand and provides some measure of hope that something can be done without giving false reassurance

the newly diagnosed client with parkinsons disease asks the nurse 'why cant i control these tremors?' which is the nurses best response? a. you can control the tremors when you concentrate and focus on the cause b. the tremors are caused by the lack of dopamine in the brain. medication may help c. you have too much acetylcholine in your brain causing the tremors but they will get better with time d. you are concerned about the tremors? if you want to talk i would like to hear how you feel

d the nurse should not assign assessing, teaching, or evaluation to the LPN evaluating the clients ability to perform self catheterization should not be delegated to the LPN/LVN

the nurse and LPN are caring for a group of clients. which nursing task should not be delegated to the LPN? a. administer a skeletal muscle relaxant to a client diagnosed with lower back pain b. discuss bowel regimen medications with HCP for the client on strict bedrest c. draw morning blood work on a client with bacterial meningitis d. teach self catheterization to the client diagnosed with MS

c the LPN can demonstrate how to use adaptive clothing

the nurse and an LPN are caring for clients in a rheumatologists office. which task can the nurse assign to the LPN? a. administer methotrexate, an antineoplastic medication IV b. assess the lung sounds of a client with RA who is coughing c. demonstrate hoe to used clothing equipped with velcro fasteners d. discuss the methods of birth control compatible with treatment medications

a the nurse should not delegate feeding a client who is at risk for complications during feeding. this requires judgement that the UAP is not expected to possess

the nurse and the UAP are caring for clients on the med surg unit which task should not be assigned to the UAP? a. feeds the 69 year old client with parkinsons who has difficulty swallowing b. turn and reposition the 89 year old client with parkinsons who has a pressure ulcer c. assist the 54 year old client with parkinsons with toilet training activities d. obtain VS on a 72 year old client diagnosed with pneumonia secondary to parkinsons disease

b this is stating a fact and offering self. both are therapeutic techniques for conversations

the nurse enters the room of a client diagnosed with acute exacerbation of MS and finds the client crying. which statement is the most therapeutic response for the nurse to make? a. why are you crying? the medication will help the disease b. you seem upset. i will sit down and we can talk for a while c. MS is a disease that has good times and bad times d. I will have the chaplain come and stay with you for a while

a, c, d, e muscle flaccidity is a hallmark symptom of MS. dysmetria is the inability to control muscular action characterized by overestimating range of movement. fatigue is a symptom of MS. dysphagia or difficulty swallowing is associated with MS

the nurse is admitting a client diagnosed with MS. which clinical manifestation should the nurse assess? select all that apply a. muscle flaccidity b. lethargy c. dysmetria d. fatigue e. dysphagia

a. the client has malnutrition syndrome. the nurse assesses the body and what the client has been able to eat

the nurse is admitting a client diagnosed with protein calorie malnutrition secondary to AIDS. which intervention should be the nurses first intervention? a. assess the clients body weight and ask what the client has been able to eat b. place in contact isolation and don a mask and gown before entering the room c. check the HCP orders and determine what lab tests will be done d. teach the client about TPN and monitor the subclavian IV site

d masklike facies and a shuffling gait are who clinical manifestations of PD

the nurse is admitting a client with the diagnosis of parkinsons disease. which assessment data support this diagnosis? a. crackles in the upper lung fields and jugular vein distention b. muscle weakness in the upper extremities and ptosis c. exaggerated arm swinging and scanning speech d. masklike facies and a shuffling gait

d dysphagia is a common problem of people diagnosed with MS and this places the client as risk for aspiration pneumonia. some clients diagnose with MS eventually become immobile and are at risk for pneumonia

the nurse is assessing a 48 year old client diagnosed with MS. which clinical manifestation warrants immediate intervention? a. the client has scanning speech and diplopia b. the client has dysarthria and scotomas c. the client has muscle weakness and spasticity d. the client has a congested cough and dysphagia

a, b, d initially levodopa can cause orthostatic hypotension. the client should be taught to rise slowly to prevent falls. the client may experience an 'on' effect of symptom control when the medication is effective and an 'off' effect near the time for the next dose. clients should be warned that darkening of the urine and sweat is a harmless side effect of this medication

the nurse is caring for a client newly diagnosed with parkinsons who is receiving levodopa. which interventions should the nurse implement? select all that apply a. instruct the client to rise slowly from a lying position b. teach about the on-off effects of the medication c. discuss taking the medication with meals or snacks d. tell the client that sweat and urine may become darker e. inform the client about having routine blood levels drawn

a the nurse should attempt to flush the area and get it to bleed. it is hoped this will remove contaminated blood from the body prior to infecting the nurse

the nurse is caring for a client who is HIV positive and is stuck with a stylet to start an IV. which intervention should the nurse implement first? a. flush the skin with water and try to get the area to bleed b. notify the charge nurse and complete an incident report c. report to the employee health nurse for prophylactic medications d. follow up with the infection control nurse to have lab work done

d Naproxen can cause G.I. bleeding in the stool appearance in the case that blood may be present in the stool. The healthcare provider should be notified so that action such as testing a stool specimen for occult blood and administering proton pump inhibitor's can be prescribed. The other symptoms are common in patients with RA and require further assessment and intervention but they do not indicate that the patient is experiencing adverse effects from the medication

the nurse is caring for a client with rheumatoid arthritis who is taking naproxen twice a day to reduce inflammation and joint pain. which symptom is most important to communicate to the HCP? a. joint pain worse in the morning b. dry eyes bilaterally c. round and moveable nodules under the skin d. dark colored stools

b, c many of the protease inhibitors used to treat AIDS interacts with grapefruit juice. the nurse should stop the UAP until the nurse can determine if the client is receiving a medication that would interact with the grapefruit juice. the clients meal tray does not have bodily fluids that can transmit HIV to the UAP, therefore this action warrants intervention from the nurse. the UAP needs to understand how the HIV virus is transmitted

the nurse is caring for clients diagnosed with AIDS. which actions by the UAP warrants immediate action by the nurse? select all that apply a. uses nonsterile gloves to empty the urinal b. taking a glass of grapefruit juice to the client c. dons gloves to remove the clients meal tray d. provides a tube or moisture barrier cream to the client e. fills the clients water pitcher with water and ice

c body image is a concern for people diagnosed with parkinsons disease. this client is the one client who is not experiencing expected sequelae of the disease

the nurse is caring for clients on a med surg floor. which clients should be assessed first? a. the 65 year old diagnosed with seizures who is complaining of a headache that is a 2 on a 0-10 scale b. the 24 year old client diagnosed with a T10 spinal cord injury who cannot move his toes c. the 62 year old client diagnosed with parkinsons who is crying and worried about her facial appearance d. the 62 year old client diagnosed with a CVA who has a resolving left hemiparesis

c antineoplastic drugs can be caustic to tissues therefore the clients IV sire should be assessed. the client should be assessed for any untoward reactions to the medications first

the nurse is caring for clients on a medical floor. which client should the nurse assess first? a. the client with RA complaining of pain 3 out of 10 b. the client diagnosed with SLE who has a rash across the bridge of their nose c. the client diagnosed with advanced RA who is receiving antineoplastic drugs IV d. the client diagnosed with scleroderma with has hard waxlike skin near the eyes

b these are psychosocial manifestations of PD. these should be discussed in the support meeting

the nurse is conducting a support group for clients diagnosed with parkinsons disease and their significant others. which information regarding psychosocial needs should be included in the discussion? a. the client should discuss feelings about being placed on a ventilator b. the client may have rapid mood swings and become easily upset c. pill rolling tremors will become worse when the medications is wearing off d. the client may automatically start to repeat what another person says

a Because TMPSMX can cause Steven Johnson syndrome a blistering rash indicates a need to discontinue the medication immediately. 2 L per day of fluid is adequate supervision Crystal urea and renal damage associated with TMPSMX. TMPSMX can cause hyperkalemia the nurse report the potassium level to the provider but the leg potassium level is not caused by the medication. Patient teaching about photosensitivity is needed but the nurse does not need guidance from the provider to implement this action

the nurse is evaluating a patient with HIV who is receiving trimethoprimsulfamethoxazole as a treatment for pneumocytis jiroveci pneumonia. which information is most important to communicate to the HCP? a. the patient reports a blistering rash b. the patients fluid intake is 2L/day c. the patients potassium is 3.4 d. the patient enjoys spending time outside in the sun

d the client with parkinsons disease should be instructed regarding safety measures in the home. the client should use her or his walker as support to get to the bathroom becaus e of bradykinesia. the client should sit down to put on pants and shoes to prevent falling. the client should exercise everyday in the morning when energy levels are the highest. the client should have all loose rugs in the home removed to prevent falling.

the nurse is instructing a client with parkinsons disease about preventing falls. which client statement reflects a need for further teaching? a. i can sit down to put on my pants and shoes b. i try to exercise everyday and rest when im tired. c. my son removed all loose rugs from my bedroom. d. i dont need to use my walker to get to the bathroom.

d sleep deprivation resulting from pain is common in clients diagnosed with RA. a mild sedative can increase the clients ability to sleep, promote rest, and increase the clients tolerance to pain

the nurse is planning care for a client diagnosed with RA. which intervention should be implemented? a. plan a strenuous exercise program b. order a mechanical soft diet c. maintain a keep open IV d. obtain an order for a sedative

b Nystatin should be in contact with the oral and esophageal tissues as long as possible for maximum effect. The other actions are also inappropriate and should be discussed with the student but do not require action as quickly. HIV positive patients do not require droplet or contact cautions or visitor restrictions to prevent opportunistic infections. Hot or spicy foods are not usually well tolerated in patients with oral or esophageal fungal infections

the nurse is supervising a student nurse who is caring for a client with HIV. the patient has severe espohagitis caused by candidia albicans. which action by the student nurse requires the most rapid intervention by the nurse? a. putting on a mask and gown before entering the room b. giving the patient a glass of water after administering the prescribed oral nystatin suspension c. suggesting that the patient should order chile con carne of chicken soup for the next meal d. placing a 'no visitors' sign on the door of the clients room

b The collection of data used to evaluate the therapeutic and adverse effects of medication is included in the LPN/LVN education and scope of practice. Assistance in planning and developing teaching programs are more complex skills that require RN education. Assistance with hygiene and activities of daily living should be delegated to the UAP

the nurse is working in a hospice facility for patients with AIDS. the facility is staffed with LPN/LVNs and UAP. which action will the nurse assign to the LPN? a. assessing patients nutritional needs and individualizing diet plans to improve nutrition b. collecting data about the patients responses to medications used for pain and anorexia c. developing UAP training programs about how to lower the risk for spreading infections d. assisting patients with personal hygiene and other ADLs as needed

a, b, c, e Current guidelines indicate that anti-retroviral therapy for HIV should be initiated as soon as possible after HIV diagnosis. Although ongoing substance abuse is a risk factor for poor adherence anti-retroviral therapy can be initiated on strategies to improve adherence are used. Strategies include directly observing patients taking medications needle exchange programs in referring patients for substance abuse treatment

the nurse is working with a patient woh has a new diagnosis of HIV and who reports current use of injectable heroin and methamphetamine. which actions by the nurse are appropriate? select all that apply a. refer the patient to a substance abuse treatment program b. plan for the patient to participate in a needle exchange program c. coordinate the patients schedule for directly observed antiretroviral medications d. instruct the patient that ingoing injectable drug use is a contraindication for antiretroviral therapy e. provide patient education about the risk of transmitting HIV to others when haring needles

a Supplying sterile injections supplies to patients who are at risk for HIV infection can be done by staff members with UAP education. Assessing for high-risk behaviors education and community assessment are RN level skills

the nurse manager in a public health department is implementing a plan to reduce the incidence of infections with HIV in the community. which nursing action will be delegated to UAP working for the agency? a. supplying IV drug users with sterile injection equipment such and needles and syringes b. interviewing patients about behaviors that indicate a need for annual HIV testing c. teaching high risk community members about the use of condoms in preventing HIV infection d. assessing the community to determine which population groups to target for education

d The increase of viral load indicates ineffective therapy which will require further evaluation and treatment. The patient may not be adhering to the prescribed regimen or resistance to the antiviral medications may have developed. Nausea anemia and hyperglycemia are common adverse effects with anti-retroviral therapy and may require further evaluation but the most concerning finding is the lack of effectiveness of the medication

the nurse obtains this information when assessing a patient with HIV is taking antiretroviral therapy. which finding is most important to report to the HCP? a. blood glucose of 144 b. HGB level of 10.9 c. patient reports frequent nausea d. the patients viral load has increased

a flushed warm skin with tented turgor indicates dehydration. the HCP should be notified immediately for fluid orders of other orders to correct the reason for dehydration

the nurse on a medical floor is caring for clients diagnosed with AIDS. which client should be seen first? a. the client who has flushed, warm skin with tented turgor b. the client who states the staff ignore the call light c. the client whose VS are T 99.9, P101, R 26, BP 110/68 d. the client who is unable to provide a sputum specimen

a this will assist the client and significant other to maintain a close relationship without putting undue pressure on the client

the nurse writes the client problem of 'altered sexual function' for a male client diagnosed with MS. which intervention should be implemented? a. encourage the couple to explore alternative ways of maintaining intimacy b. make an appointment with a a psychotherapist to counsel the couple c. explain daily exercise will help increase the libido and sexual arousal d. discuss the importance of keeping physically calm during sexual intercourse

c one of the symptoms of PD is a forward shuffling gait so being able to walk upright without stumbling would indicate that the medication is effective

the older adult client diagnosed with parkinsons disease has been prescribed the combination medication carbidopa/levodopa. which data indicated the medication is effective? a. the client has cogwheel motions when swinging the arms b. the client does not display emotions when discussing the illness c. the client is able to walk upright without stumbling d. the client eats 30-40% of meals within an hour

c although AZT, a nucleoside reverse transcriptase inhibitor is a pregnancy cat c medication, research has proved that taking the drug during pregnancy reduces the risk of maternal-to-fetal transmission of the HIV virus by almost 70%. this is the only medication approved for this purpose

the pregnant clients HIV test is positive. which medication should the client take to prevent transmission to the fetus? a. efavirenz b. lopanivir c. zidovudine d. ganciclovir

d abstinence is the only guarantee the client will not contract a STD including AIDS. an individual who is in a monogamous relationship with another individual

the school nurse is preparing to teach a health class to 9th graders regarding STDs. which information regarding AIDS should be included? a. females taking birth control pills are protected from transmitting STDs b. protected sex is no longer an issue because there is a vaccine for the HIV virus c. adolescents with a normal immune system are not at risk for developing AIDS d. abstinence is the only guarantee of not becoming infected with STDs

b CDC guidelines indicate that a post exposure prophylaxis is to be used antiretroviral drug should be started as soon as possible preferably with an hours of exposure. It is important that staff understand that reporting the possible exposure is a priority so that the rapid assessment and treatment can be initiated. The other statements are Also true but will not impact the efficacy of any needed treatment

when the occupational health nurse is teaching UAP about bloodborne pathogen exposure and HIV risk, which information is most important to emphasize? a. occupational transmission of HIV from patients to health care workers is relatively rare b. occupational exposure to HIV containing fluids should be reported immediately to the supervisor c. treatment for occupational exposure to HIV may include use of antiretroviral medications d. post exposure treatment will include HIV testing at baseline and at several intervals after the exposure

a sulfasalazine an anti-rheumatic may cause an orange or yellowish discoloration of urine and the skin/ this is expected and not significant

which assessment data should the nurse expect for the client diagnosed with RA who is taking sulfasalazine? a. orange or yellowish discoloration of the urine b. ulcers and irritation of the mouth c. ecchymosis of the lower extremities d. a red raised skin rash over the back

c anticholinergic medications such as benzotropine, block cholinergic receptors in the eye and may precipitate or aggravate glaucoma

which client diagnosed with parkinsons should the nurse question administering benztropine? a. the client diagnosed with CHF b. the client who has had an MI c. the client diagnosed with glaucoma d. the client who is undergoing hip replacement surgery

a, e methotrexate a DMARD causes bone marrow depression which may lead to abnormal bleeding therefore the client should use a soft bristled toothbrush. NSAIDs and salicylates taken with methotrexate in the blood leading to toxicity. careful monitoring of methotrexate levels is required

which instruction should the nurse discuss with the client diagnosed with RA who is prescribed methotrexate? select all that apply a. use a sift bristled tooth brush when brushing teeth b. wear warm clothes when it is less than 40 degrees c. gargle with mouthwash atleast 4 times a day d. use a sunscreen with an SPF 15 or lower when outside e. take NSAIDS only as prescribed by the HCP while taking this medication

c clients diagnosed with AIDS should be encouraged to discuss their end of like issue with the significant others and to put those wishes into writing. this is important for all clients not just those diagnosed with AIDS

which intervention is an important psychosocial consideration for the client diagnosed with AIDS? a. perform thorough head to toe assessment b. maintain the clients ideal body weight c. complete an advanced directive d. increase the clients activity tolerance

c memory deficits are cognitive impairments. the client may also develop dementia

which is a cognitive problem associated with parkinsons disease? a. emotional lability b. depression c. memory deficits d. paranoia